Postoperative hypertensive-hypervolaemic-haemodilution (Triple H) therapy in the treatment of vasospasm following aneurysmal subarachnoid haemorrhage.

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dc.contributor.authorGupta, Den_US
dc.contributor.authorSharma, B Sen_US
dc.contributor.authorGupta, S Ken_US
dc.contributor.authorBapuraj, Ren_US
dc.contributor.authorKhosla, V Ken_US
dc.date.accessioned2000-06-06en_US
dc.date.accessioned2009-06-03T12:33:56Z
dc.date.available2000-06-06en_US
dc.date.available2009-06-03T12:33:56Z
dc.date.issued2000-06-06en_US
dc.description.abstractTwenty five patients with post operative ischaemic deficits, following clipping of intracranial aneurysms, were studied. Hypertensive-hypervolaemic-haemodilution (triple H) therapy was given to all patients using colloids and crystalloids. CVP was used to monitor the fluid therapy. Dopamine was needed in 22 patients to elevate the systemic blood pressure. Vasospasm was confirmed in 20 patients with transcranial doppler studies (TCD). 20 (80%) patients survived, 10 (40%) with good outcome, 7 (28%) with fair, 2 (8%) with poor outcome and 1 (4%) with vegetative state. There were 5 (20%) deaths, 4 of which occurred due to infarct. All these patients had poor Hunt and Hess grade at admission, high Fisher grade haemorrhages in the initial CT scan and/or required prolonged temporary clipping at surgery. One death occurred due to central venous line induced septicaemia. The duration of 'triple H therapy' amongst the survivors varied from 2-7 days with an average of 4.6 days. The complications of 'triple H therapy' included hypokalaemia (3 patients), haemorrhagic infarct (1 patient) and septicaemia (1 patient). It is concluded that 'triple H therapy' is useful in treating vasospasm induced ischaemic deficits. It worsens brain oedema in presence of acute infarcts and hence is contraindicated in such patients. A further study involving a larger number of patients with strict haemodynamic and ICP monitoring is suggested to determine the usefulness of individual components of 'triple H therapy'.en_US
dc.description.affiliationDepartments of Neurosurgery and Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.en_US
dc.identifier.citationGupta D, Sharma BS, Gupta SK, Bapuraj R, Khosla VK. Postoperative hypertensive-hypervolaemic-haemodilution (Triple H) therapy in the treatment of vasospasm following aneurysmal subarachnoid haemorrhage. Neurology India. 2000 Jun; 48(2): 126-31en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/121638
dc.language.isoengen_US
dc.source.urihttps://neurologyindia.comen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshDopamine --therapeutic useen_US
dc.subject.meshFemaleen_US
dc.subject.meshHemodilutionen_US
dc.subject.meshHumansen_US
dc.subject.meshHypotension --drug therapyen_US
dc.subject.meshHypovolemia --therapyen_US
dc.subject.meshIntracranial Aneurysm --complicationsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPlasma Substitutes --therapeutic useen_US
dc.subject.meshPostoperative Careen_US
dc.subject.meshPostoperative Complications --drug therapyen_US
dc.subject.meshSubarachnoid Hemorrhage --complicationsen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshVasospasm, Intracranial --etiologyen_US
dc.titlePostoperative hypertensive-hypervolaemic-haemodilution (Triple H) therapy in the treatment of vasospasm following aneurysmal subarachnoid haemorrhage.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
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